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  • Writer's pictureAhsan Malyk

How do Health Insurance Companies Make Money?

Risk acceptance and diversification are the cornerstones of insurance firms' business models. The fundamental insurance approach combines the risk from several payers and distributes it over a broader portfolio.

Most insurance firms have two main means of making money: charging insurance premiums in return for coverage, and then reinvesting those premiums in other assets that provide interest. Insurance companies strive to market efficiently and keep overhead to a minimum, just like any private business.

Price and Risk Acceptance

Health insurance firms, property insurance companies, and financial guarantors all have different revenue models. But any insurer's first job is to assess the risk and set a price for taking it on.

Consider the case where the insurance provider is promoting a policy with a $100,000 conditional payoff. Based on the duration of the insurance, it must determine how likely it is for a potential buyer to trigger the conditional payment and increase that risk.

In these circumstances, insurance underwriting is essential. Without sound underwriting, the insurance provider would overcharge some clients while undercharging others for assuming risk. The least risky consumers can be priced out as a result, eventually leading to a rise in rates. If a corporation sells its risk appropriately, premiums should cover more of its conditional payment costs than it spends on them.

In a way, insurance claims are the genuine product of an insurer. The business must process customer claims, verify their accuracy, and submit payment. This adjustment procedure is required to weed out fictitious claims and lower the company's risk of losing.

Earnings and Revenue from Interest

Let's say that $1 million in premiums are paid to the insurance provider for its policies. It might keep the cash on hand or put it in a savings account, but those options are less effective: Those funds will, at the very least, be subject to the danger of inflation. Instead, the business might invest its money in certain short-term assets.

As a result, the business generates more interest income while it waits for potential rewards. Treasury bonds, AAA-rated corporate bonds, and interest-bearing cash equivalents are common items of this category.


Reinsurance is a strategy used by some businesses to lower risk. Reinsurance is the insurance that insurance firms purchase to safeguard themselves against disproportionate losses resulting from significant exposure. Reinsurance is essential to insurance firms' efforts to maintain their financial stability and prevent payout-related default, and regulators require it for businesses of a specific size and kind.

For instance, based on models that indicate the minimal likelihood of a storm affecting a geographic area, an insurance company may write excessive amounts of hurricane insurance. If the unthinkable occurred and a hurricane did strike that area, the insurance firm might suffer huge damages. Insurance firms might run out of business every time a natural disaster strikes if reinsurance doesn't take some of the risks off the table.

Unless it is reinsured, regulators rule that an insurance firm can only offer a policy with a cap of 10% of its value. Reinsurance enables insurance companies to transfer risks, making them more aggressive in capturing market share. Reinsurance also smoothes insurance firms' normal swings, which can result in considerable variations in earnings and losses.

In many ways, it resembles arbitrage for insurance companies. They charge more for insurance to individual customers, but the prices drop when they insure these policies in large quantities.

Assessing Insurers

Reinsurance makes the insurance industry more suitable for investors by reducing business fluctuation.

Like any other non-financial business, companies in the insurance sector are rated according to their profitability, projected growth, payout, and risk. However, there are additional difficulties unique to the industry. Due to the absence of investments in fixed assets by insurance companies, very little depreciation and very little capital expenditures are reported.

Additionally, since there are no traditional working capital records, figuring out the insurer's working capital is difficult. Instead of focusing on equity measurements like price-to-earnings (P/E) and price-to-book (P/B) ratios, analysts do not use metrics that take into account firm and enterprise values. To analyse the companies, analysts perform ratio analysis by computing ratios that are specific to the insurance industry.

Insurance firms with high projected growth, big payouts, and little risk typically have higher P/E ratios. For insurance firms with strong projected earnings growth, a low-risk profile, high payout, and high return on equity, P/B is greater. Return on equity has the most significant impact on the P/B ratio when all other factors are held constant.

Analysts must contend with additional complication factors when comparing P/E and P/B ratios across the insurance industry. Insurance providers budget for potential claims costs in advance. The P/E and P/B ratios may be too high or too low if the insurer estimates these provisions too conservatively or too aggressively.

Comparability throughout the insurance industry is further hampered by the degree of diversification. Insurance companies frequently operate in one or more different insurance sectors, such as life, property, and casualty insurance. Insurance businesses have varying risks and returns depending on their level of diversification, which affects their P/E and P/B ratios throughout the industry.

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